Neurobehavioral status check
Facility: Labette Health
Billing Code: 96116 (CPT)
- CPT Billing Code: 96116
- Insurance Median: $288
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.31x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $220.6 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Uhccp | $89 | 40% |
| Medicaid / KanCare | $90 - $288 | 41% |
| Healthy Blue | $91 | 41% |
| Humana | $288 | 131% |
| Wellcare | $288 | 131% |
| UnitedHealthcare | $288 | 131% |
| Blue Cross Blue Shield | $288 | 131% |
| Kansas Superior Select | $297 | 135% |
| Ambetter / Centene | $331 | 150% |
| Montgomery County | $527 | 239% |
Consumer Guidance & Cost Commentary
For the CPT code 96116, "Neurobehavioral status check," Labette Health in Parsons, KS, has a negotiated rate of $288.00, which aligns with the state average for this service. While the facility is an Acute Care Hospital owned by the local government, the data shows no specific cash or median paid amounts listed for this procedure. However, for patients with high-deductible plans, paying cash directly can sometimes be more cost-effective if the insurance negotiated rate exceeds the cash price, though current data does not provide a cash rate for comparison. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill.
The Medicare benchmark for this service is $220.60, which serves as a baseline for evaluating the facility's pricing markup. The negotiated rate of $288.00 is approximately 1.3 times the Medicare amount, reflecting standard commercial pricing dynamics where administrative costs and contract structures influence the final price. Patients should be aware that hospitals often issue summary bills that obscure individual charges, so requesting a full itemized CPT-coded statement is a critical step to identify any errors, unbundled codes, or services not rendered. If a patient receives a bill that appears higher than expected, they should dispute it in writing with the billing supervisor rather than accepting the summary invoice, as over 80% of hospital bills contain errors that can be corrected through a formal audit.